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Failures on the Diamond Princess Shadow Another Cruise Ship Outbreak Failures on the Diamond Princess Shadow Another Cruise Ship Outbreak
(3 months later)
The email to Princess Cruises was peppered with typos and awkward grammar, but the warning was unmistakable. An 80-year-old passenger had tested positive for the new coronavirus after getting off the Diamond Princess cruise ship in Hong Kong.The email to Princess Cruises was peppered with typos and awkward grammar, but the warning was unmistakable. An 80-year-old passenger had tested positive for the new coronavirus after getting off the Diamond Princess cruise ship in Hong Kong.
“Would kindly inform the ship related parties and do the necessary disinfection,” Princess’s port representative wrote on Feb. 1, relaying a warning from Hong Kong health officials. “Many thanks!”“Would kindly inform the ship related parties and do the necessary disinfection,” Princess’s port representative wrote on Feb. 1, relaying a warning from Hong Kong health officials. “Many thanks!”
Nothing happened. Princess says it believes the alert sat unread in unmonitored inboxes. Grant Tarling, the company’s top doctor and the person in charge of responding to outbreaks, said he hadn’t learned about the infection until the following day — after being alerted to a post on social media.Nothing happened. Princess says it believes the alert sat unread in unmonitored inboxes. Grant Tarling, the company’s top doctor and the person in charge of responding to outbreaks, said he hadn’t learned about the infection until the following day — after being alerted to a post on social media.
The fumbled alert was just the beginning of a broader breakdown by both the company and the Japanese authorities who quarantined the ship in Yokohama. Hobbled by confusion and mistakes, they played down the risk of infection, ignored best medical practice for evacuating passengers, and activated only low-level protocols for dealing with outbreaks. Ultimately, eight people died and more than 700 were infected, including some government officials.The fumbled alert was just the beginning of a broader breakdown by both the company and the Japanese authorities who quarantined the ship in Yokohama. Hobbled by confusion and mistakes, they played down the risk of infection, ignored best medical practice for evacuating passengers, and activated only low-level protocols for dealing with outbreaks. Ultimately, eight people died and more than 700 were infected, including some government officials.
Now, those failures have taken on fresh urgency as Princess and Dr. Tarling deal with yet another coronavirus cluster, on a cruise ship that has been turned away from port in San Francisco. A passenger who recently got off the cruise died of the virus last week, and 21 people have since tested positive.Now, those failures have taken on fresh urgency as Princess and Dr. Tarling deal with yet another coronavirus cluster, on a cruise ship that has been turned away from port in San Francisco. A passenger who recently got off the cruise died of the virus last week, and 21 people have since tested positive.
Thousands of passengers have been told to stay in their rooms as the cruise company and the American authorities have scrambled to figure out a plan. The ship is expected to dock in Oakland, Calif., on Monday and passengers will be quarantined onshore.Thousands of passengers have been told to stay in their rooms as the cruise company and the American authorities have scrambled to figure out a plan. The ship is expected to dock in Oakland, Calif., on Monday and passengers will be quarantined onshore.
In conversations onboard, passengers have been asking, “Will we become another Diamond Princess?” said Bill Pearce, a 54-year-old from Lafayette, Calif.In conversations onboard, passengers have been asking, “Will we become another Diamond Princess?” said Bill Pearce, a 54-year-old from Lafayette, Calif.
“Whatever’s the quickest way to get home, I’m all for it. I’d rather not be on the ship,” he said. “Not being able to walk more than six feet in any direction — it’s like being in a jail cell.”“Whatever’s the quickest way to get home, I’m all for it. I’d rather not be on the ship,” he said. “Not being able to walk more than six feet in any direction — it’s like being in a jail cell.”
The crisis on the Diamond Princess exposes the vulnerabilities in the patchwork of international agreements, national laws and corporate policies governing the health and safety of the $150 billion cruise industry that carries 30 million passengers a year.The crisis on the Diamond Princess exposes the vulnerabilities in the patchwork of international agreements, national laws and corporate policies governing the health and safety of the $150 billion cruise industry that carries 30 million passengers a year.
After the infection was confirmed, company officials incorrectly assumed that the immediate risk was minimal because the sick passenger had disembarked. Health authorities recommended action immediately. “We advise thorough environmental cleansing and disinfection of the cruise,” Albert Lam, an epidemiologist for the Hong Kong government, wrote to the company on Feb. 2.After the infection was confirmed, company officials incorrectly assumed that the immediate risk was minimal because the sick passenger had disembarked. Health authorities recommended action immediately. “We advise thorough environmental cleansing and disinfection of the cruise,” Albert Lam, an epidemiologist for the Hong Kong government, wrote to the company on Feb. 2.
The company says it stepped up cleaning the next day. But it initiated only the lowest-level protocols for outbreaks. “There’s no point in going and start cleaning the ship when we really didn’t know what, if any, risk there was onboard,” Dr. Tarling said in an interview.The company says it stepped up cleaning the next day. But it initiated only the lowest-level protocols for outbreaks. “There’s no point in going and start cleaning the ship when we really didn’t know what, if any, risk there was onboard,” Dr. Tarling said in an interview.
When the Japanese authorities boarded the vessel, they, too, ignored medical guidelines, by leaving potentially exposed passengers onboard during testing rather than taking them ashore as recommended.When the Japanese authorities boarded the vessel, they, too, ignored medical guidelines, by leaving potentially exposed passengers onboard during testing rather than taking them ashore as recommended.
The Japanese government and company still disagree on who was — or should have been — in charge. So the responsibilities for quarantining nearly 2,700 passengers fell mostly to about 1,000 low-paid ship workers who were given inadequate safety gear and guidance.The Japanese government and company still disagree on who was — or should have been — in charge. So the responsibilities for quarantining nearly 2,700 passengers fell mostly to about 1,000 low-paid ship workers who were given inadequate safety gear and guidance.
Dr. Tarling, the chief medical officer for Princess’s parent company, Carnival Corporation, oversaw the response from California. He was unaware of the working conditions onboard. He said crew members had followed the protocols for a person “in quarantine or isolation in a hospital.”Dr. Tarling, the chief medical officer for Princess’s parent company, Carnival Corporation, oversaw the response from California. He was unaware of the working conditions onboard. He said crew members had followed the protocols for a person “in quarantine or isolation in a hospital.”
In reality, a crew member often wore the same pair of gloves to deliver food to dozens of cabins at a time, door-to-door and face-to-face with passengers, a potential source of infection. They also collected dirty dishes and used linens without full protective gear.In reality, a crew member often wore the same pair of gloves to deliver food to dozens of cabins at a time, door-to-door and face-to-face with passengers, a potential source of infection. They also collected dirty dishes and used linens without full protective gear.
An outbreak of a new virus aboard a crowded ship unquestionably presented high-stakes difficulties. Princess says it did the best job possible in the face of unprecedented challenges.An outbreak of a new virus aboard a crowded ship unquestionably presented high-stakes difficulties. Princess says it did the best job possible in the face of unprecedented challenges.
But in a series of interviews, company officials offered contradictory and changing accounts about their response. In the end, nearly 48 hours elapsed between the alert on Feb. 1 and the captain’s announcement to the ship on Feb. 3 that a passenger had been infected, giving the virus time to spread.But in a series of interviews, company officials offered contradictory and changing accounts about their response. In the end, nearly 48 hours elapsed between the alert on Feb. 1 and the captain’s announcement to the ship on Feb. 3 that a passenger had been infected, giving the virus time to spread.
Princess officials could not point to the social media post, or the platform, that they say tipped them off. They said it took Dr. Tarling until the night of Feb. 2 to confirm that a former passenger had tested positive.Princess officials could not point to the social media post, or the platform, that they say tipped them off. They said it took Dr. Tarling until the night of Feb. 2 to confirm that a former passenger had tested positive.
Company emails show that he knew by that morning. In an email to a Hong Kong doctor, he listed the patient’s name, his hospital wing, his traveling companions and the date of the diagnosis.Company emails show that he knew by that morning. In an email to a Hong Kong doctor, he listed the patient’s name, his hospital wing, his traveling companions and the date of the diagnosis.
The subject line of his email began: “Confirmed Coronavirus Case.”The subject line of his email began: “Confirmed Coronavirus Case.”
Containment procedures for an outbreak unfold on a continuum.Containment procedures for an outbreak unfold on a continuum.
Basic precautions might include encouraging handwashing, eliminating self-service at buffets and increasing cleaning. More serious matters might prompt crews to discourage handshaking, disinfect the ship or cancel social events. Outbreaks of highly infectious diseases like Ebola have their own stringent protocols.Basic precautions might include encouraging handwashing, eliminating self-service at buffets and increasing cleaning. More serious matters might prompt crews to discourage handshaking, disinfect the ship or cancel social events. Outbreaks of highly infectious diseases like Ebola have their own stringent protocols.
The response aboard the Diamond Princess reflected concern, but not a major one. The buffets remained open as usual. Onboard celebrations, opera performances and goodbye parties continued.The response aboard the Diamond Princess reflected concern, but not a major one. The buffets remained open as usual. Onboard celebrations, opera performances and goodbye parties continued.
“We immediately increased our already robust sanitation protocols,” Gennaro Arma, the ship’s captain, said in response to questions submitted through Princess. He said the crew had increased the number of hand sanitizers, rotated the buffet utensils more frequently and stepped up cleaning.“We immediately increased our already robust sanitation protocols,” Gennaro Arma, the ship’s captain, said in response to questions submitted through Princess. He said the crew had increased the number of hand sanitizers, rotated the buffet utensils more frequently and stepped up cleaning.
Passengers aboard the Diamond Princess say they noticed few ship-wide changes after the announcement of the infected passenger. But some crew members began giving out their own more cautious advice, making some passengers suspicious that the risks were higher than the company was letting on. At the end of a trivia game, for example, a worker told passengers not to hand back their pencils.Passengers aboard the Diamond Princess say they noticed few ship-wide changes after the announcement of the infected passenger. But some crew members began giving out their own more cautious advice, making some passengers suspicious that the risks were higher than the company was letting on. At the end of a trivia game, for example, a worker told passengers not to hand back their pencils.
“He said, ‘Hold onto your pencils and you can consider yourself a winner,’” said Carol Montgomery, 67, a retired administrative assistant from San Clemente, Calif.“He said, ‘Hold onto your pencils and you can consider yourself a winner,’” said Carol Montgomery, 67, a retired administrative assistant from San Clemente, Calif.
The crew member also advised them to avoid handrails. “It was like he was trying to tell us something,” Ms. Montgomery said.The crew member also advised them to avoid handrails. “It was like he was trying to tell us something,” Ms. Montgomery said.
Underpinning the company’s approach was an optimistic, but ultimately inaccurate, belief that perhaps danger had been averted.Underpinning the company’s approach was an optimistic, but ultimately inaccurate, belief that perhaps danger had been averted.
The 80-year-old infected passenger had reported no symptoms to the medical staff while onboard. And he had disembarked more than a week earlier, along with his daughter and their two traveling companions.The 80-year-old infected passenger had reported no symptoms to the medical staff while onboard. And he had disembarked more than a week earlier, along with his daughter and their two traveling companions.
“They were off the ship,” Dr. Tarling said. “There’s nothing to believe that we have to put face masks on every single guest.”“They were off the ship,” Dr. Tarling said. “There’s nothing to believe that we have to put face masks on every single guest.”
Dr. Tarling also did not order the crew to begin what is known as contact-tracing, the painstaking task of questioning everybody and identifying who had been in contact with the infected passenger. Infectious disease experts say that the process should begin immediately and that anyone who was in close contact should be isolated.Dr. Tarling also did not order the crew to begin what is known as contact-tracing, the painstaking task of questioning everybody and identifying who had been in contact with the infected passenger. Infectious disease experts say that the process should begin immediately and that anyone who was in close contact should be isolated.
Dr. Tarling said Japanese health officials planned to do the contact tracing in a matter of hours, when the ship arrived in Yokohama on Feb. 3. Until then, he said, he considered only the elderly man and his traveling party to be “close contacts.”Dr. Tarling said Japanese health officials planned to do the contact tracing in a matter of hours, when the ship arrived in Yokohama on Feb. 3. Until then, he said, he considered only the elderly man and his traveling party to be “close contacts.”
That is a narrow interpretation. The World Health Organization’s definition covers dining partners, anyone who had face-to-face contact with the patient — and certainly passengers who had shared a tour bus with him days earlier.That is a narrow interpretation. The World Health Organization’s definition covers dining partners, anyone who had face-to-face contact with the patient — and certainly passengers who had shared a tour bus with him days earlier.
No restrictions were placed on passengers until around 11 p.m., when Japanese medical teams boarded the ship and ordered everyone to their cabins.No restrictions were placed on passengers until around 11 p.m., when Japanese medical teams boarded the ship and ordered everyone to their cabins.
Two days later, when the first lab results came back, Japan reported that 10 people had tested positive.Two days later, when the first lab results came back, Japan reported that 10 people had tested positive.
“We were as surprised as the Japanese were that actually there were more positive samples on the ship,” Dr. Tarling said.“We were as surprised as the Japanese were that actually there were more positive samples on the ship,” Dr. Tarling said.
Halfway around the world, in the Greek port city of Volos, an epidemiologist named Christos Hadjichristodoulou has been studying cruise ship outbreaks for nearly two decades. He served as a science adviser in the lead-up to the 2004 Summer Olympics in Athens, which used a fleet of ships to ease the hotel crunch.Halfway around the world, in the Greek port city of Volos, an epidemiologist named Christos Hadjichristodoulou has been studying cruise ship outbreaks for nearly two decades. He served as a science adviser in the lead-up to the 2004 Summer Olympics in Athens, which used a fleet of ships to ease the hotel crunch.
By happenstance, on the very day that the Diamond Princess pulled into Yokohama, Dr. Hadjichristodoulou and a team of European experts released new recommendations for cruise ships.By happenstance, on the very day that the Diamond Princess pulled into Yokohama, Dr. Hadjichristodoulou and a team of European experts released new recommendations for cruise ships.
The guidelines did not have the force of law. But experts said they were among the first protocols — if not the first — written specifically for the industry about the new coronavirus.The guidelines did not have the force of law. But experts said they were among the first protocols — if not the first — written specifically for the industry about the new coronavirus.
Those guidelines said that close contacts of a confirmed case should be evacuated and quarantined on shore, a step that is now supposed to happen with the ship off California’s coast after several days of waiting. On the Diamond Princess, that would have meant removing many, if not all, of the 273 people selected for the first round of testing.Those guidelines said that close contacts of a confirmed case should be evacuated and quarantined on shore, a step that is now supposed to happen with the ship off California’s coast after several days of waiting. On the Diamond Princess, that would have meant removing many, if not all, of the 273 people selected for the first round of testing.
Instead, the Japanese government asked them to stay in their rooms while awaiting test results. In practice, passengers still moved about and ate at buffets.Instead, the Japanese government asked them to stay in their rooms while awaiting test results. In practice, passengers still moved about and ate at buffets.
Updated June 12, 2020
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
When the first batch of positive results were reported on the morning of Feb. 5, the Japanese authorities ordered a ship-wide quarantine. Confirmed cases would be evacuated to hospitals, but everyone else would remain aboard, isolated in their cabins.When the first batch of positive results were reported on the morning of Feb. 5, the Japanese authorities ordered a ship-wide quarantine. Confirmed cases would be evacuated to hospitals, but everyone else would remain aboard, isolated in their cabins.
“The approach they followed is not recommended for many reasons,” Dr. Hadjichristodoulou said. He would not criticize decisions made under pressure, but said it was clear the virus would spread. “We expected this,” he said.“The approach they followed is not recommended for many reasons,” Dr. Hadjichristodoulou said. He would not criticize decisions made under pressure, but said it was clear the virus would spread. “We expected this,” he said.
Japanese health officials say that some local authorities feared allowing potentially infected passengers ashore. And the country could not immediately quarantine a large number of people. “It’s easy to say that they should be moved to an onshore facility,” said Dr. Yasuyuki Sahara, a senior assistant minister in Japan’s health ministry. “But in reality it is not so easy.”Japanese health officials say that some local authorities feared allowing potentially infected passengers ashore. And the country could not immediately quarantine a large number of people. “It’s easy to say that they should be moved to an onshore facility,” said Dr. Yasuyuki Sahara, a senior assistant minister in Japan’s health ministry. “But in reality it is not so easy.”
Dr. Hadjichristodoulou, who also leads a team of World Health Organization advisers, said he had contacted the agency’s offices in Lyon, France, and offered to organize a group of experts to board the ship to advise. He said the offer was declined.Dr. Hadjichristodoulou, who also leads a team of World Health Organization advisers, said he had contacted the agency’s offices in Lyon, France, and offered to organize a group of experts to board the ship to advise. He said the offer was declined.
A W.H.O. spokesman said he would not discuss the group’s internal discussions. Dr. Sahara said the ministry had no record of the offer.A W.H.O. spokesman said he would not discuss the group’s internal discussions. Dr. Sahara said the ministry had no record of the offer.
One W.H.O. consultant from the Manila office provided advice in the health ministry’s Tokyo office but never boarded the ship.One W.H.O. consultant from the Manila office provided advice in the health ministry’s Tokyo office but never boarded the ship.
Quarantining thousands of people is a huge operation requiring far more gear and supplies than any cruise ship carries. Confining people in shared rooms has its own challenges, as does feeding them and keeping them entertained so they won’t be tempted to leave their cabins.Quarantining thousands of people is a huge operation requiring far more gear and supplies than any cruise ship carries. Confining people in shared rooms has its own challenges, as does feeding them and keeping them entertained so they won’t be tempted to leave their cabins.
Japan’s foreign minister, Toshimitsu Motegi, said in a parliamentary session that the responsibility should not have fallen solely on Japan.Japan’s foreign minister, Toshimitsu Motegi, said in a parliamentary session that the responsibility should not have fallen solely on Japan.
“Japan is not the only state that is obliged to conduct measures to prevent the expansion of infection,” Mr. Motegi said. He suggested international law was unclear as to whether both the country where the ship was officially licensed — Britain — and the cruise operator should share the burden.“Japan is not the only state that is obliged to conduct measures to prevent the expansion of infection,” Mr. Motegi said. He suggested international law was unclear as to whether both the country where the ship was officially licensed — Britain — and the cruise operator should share the burden.
Princess said it had followed Japan’s lead from the moment its health officials boarded the ship. “When we have other outbreaks like norovirus, we send our teams to the ship,” Dr. Tarling said. “Here, we’re sort of taking direction and seeing how we can best make it work.”Princess said it had followed Japan’s lead from the moment its health officials boarded the ship. “When we have other outbreaks like norovirus, we send our teams to the ship,” Dr. Tarling said. “Here, we’re sort of taking direction and seeing how we can best make it work.”
That responsibility fell to the crew. Cruise jobs are notorious for long hours and low pay. A supervisory kitchen worker for Princess, for example, made $1,949 a month and was expected to work up to 13 hours a day, seven days a week, for six months straight, according to a 2017 contract.That responsibility fell to the crew. Cruise jobs are notorious for long hours and low pay. A supervisory kitchen worker for Princess, for example, made $1,949 a month and was expected to work up to 13 hours a day, seven days a week, for six months straight, according to a 2017 contract.
Those crew members drill for many eventualities, said Iain Hay, whose company, Anchor Hygiene, conducts training for cruise companies. “But,” he said, “there was no drilling for something like this.”Those crew members drill for many eventualities, said Iain Hay, whose company, Anchor Hygiene, conducts training for cruise companies. “But,” he said, “there was no drilling for something like this.”
On the Diamond Princess, crew members delivered three meals a day to close to 1,500 staterooms. Early in the quarantine, they served food on china. While crew members wore masks and gloves, they risked spreading — or contracting — the virus whenever they opened state room doors and passed in trays of food.On the Diamond Princess, crew members delivered three meals a day to close to 1,500 staterooms. Early in the quarantine, they served food on china. While crew members wore masks and gloves, they risked spreading — or contracting — the virus whenever they opened state room doors and passed in trays of food.
“I’d give them a coffee cup and they’d give me back an apple,” said Melanie Haering, 58, whose husband, John, was hospitalized with the virus. “It was an exchange like that — even though your hand is gloved, your hand has still been soiled from the cabin next door.”“I’d give them a coffee cup and they’d give me back an apple,” said Melanie Haering, 58, whose husband, John, was hospitalized with the virus. “It was an exchange like that — even though your hand is gloved, your hand has still been soiled from the cabin next door.”
Even after switching to paper and plastic, crew members still delivered meals into rooms rather than leaving them on the floor outside, as Dr. Tarling believed happened. Passengers who were evacuated to military bases in California and Texas said workers there left food outside.Even after switching to paper and plastic, crew members still delivered meals into rooms rather than leaving them on the floor outside, as Dr. Tarling believed happened. Passengers who were evacuated to military bases in California and Texas said workers there left food outside.
Experts say the crew was not equipped to carry out the quarantine, so lapses were inevitable. “Look at how infectious-disease teams operate anywhere in the world. That is their job,” said Dr. Kate Bunyan, a former medical director for Carnival U.K. “They are not waiters in their day jobs.”Experts say the crew was not equipped to carry out the quarantine, so lapses were inevitable. “Look at how infectious-disease teams operate anywhere in the world. That is their job,” said Dr. Kate Bunyan, a former medical director for Carnival U.K. “They are not waiters in their day jobs.”
But if anyone from Princess objected to the quarantine, nobody is saying so. Dr. Tarling said it was the best option available.But if anyone from Princess objected to the quarantine, nobody is saying so. Dr. Tarling said it was the best option available.
The concern now is focused on the other Princess cruise thousands of miles away. On Wednesday, a passenger in California died from the coronavirus after completing a 10-day cruise to Mexico aboard that ship, the Grand Princess.The concern now is focused on the other Princess cruise thousands of miles away. On Wednesday, a passenger in California died from the coronavirus after completing a 10-day cruise to Mexico aboard that ship, the Grand Princess.
For days, the ship has idled off the coast as Princess and American officials have tried to figure out what to do. After shifting plans and significant uncertainty, they have decided to dock in Oakland, where sick passengers will be taken to hospitals in the state and others will be sent to quarantine facilities around the country.For days, the ship has idled off the coast as Princess and American officials have tried to figure out what to do. After shifting plans and significant uncertainty, they have decided to dock in Oakland, where sick passengers will be taken to hospitals in the state and others will be sent to quarantine facilities around the country.
Once again, Dr. Tarling is helping manage the crisis. Asked whether he wished he had done anything differently to contain the outbreak on the Diamond Princess, he could not point to a single decision that he would change.Once again, Dr. Tarling is helping manage the crisis. Asked whether he wished he had done anything differently to contain the outbreak on the Diamond Princess, he could not point to a single decision that he would change.
“I believe our initial response was actually pretty good,” he said.“I believe our initial response was actually pretty good,” he said.
Tiffany May contributed reporting from Hong Kong. Makiko Inoue contributed research from Tokyo, and Susan Beachy from New York.Tiffany May contributed reporting from Hong Kong. Makiko Inoue contributed research from Tokyo, and Susan Beachy from New York.